The Right-Wing Assault On Equity Programs Could Be Killing Us

Last year, conservative groups began a growing national effort to launch litigation against any program that uses race or ethnicity to target funding and other supports that address disparities and solve social problems. Although racially targeted health equity programs are not illegal, decades of legal attacks on affirmative action in education and business contracting have placed a chilling effect on initiatives designed to close health disparities among racial and ethnic minority populations. This has resulted in the unacceptable denial of life-saving resources to communities of color, particularly in the fight against HIV/AIDS.

It has been 42 years since HIV/AIDS was first recognized as a new, potentially life-threatening condition and illness. And except for the first few years of the epidemic when the incidence of HIV/AIDS among gay white men skyrocketed and then rapidly declined, Black Americans have led the nation in HIV/AIDS diagnosis rates for most of this time.

Stark racial and ethnic disparities in infections not only persist but have grown over time. In 2021, for example, Black and Latino populations represented 30 percent of the U.S. population but were 67 percent of new HIV infections nationwide. Black people in the U.S. represented 40 percent of the total.

Conservative efforts to delegitimize the use of racial and ethnic targeting strategies have contributed to the perpetuation and growth of racial and ethnic HIV disparities. Their efforts are not only wrong-headed, but they directly contradict scientific evidence showing that matching racial and ethnic service providers to their communities produces more effective health outcomes in communities of color.

Most recently, Republicans in the U.S. House of Representatives have sought to dramatically reduce or eliminate funding for critical HIV/AIDS programs, including calling for steep cuts to PEPFAR and the Minority AIDS Initiative (MAI), the only federal policy solely dedicated to addressing racial and ethnic HIV disparities in the U.S.

If they get their way, they would not only wipe out funding but endanger the lives of primarily people of color who depend on the program’s resources.

The racial and ethnic gap in access to preventative drugs like Pre-Exposure Prophylaxis (PrEP), which prevents HIV from replicating in the body, is equally concerning. While 94 percent of white individuals who could benefit from PrEP are utilizing it, only 13 percent and 24 percent of Black and Latino individuals, respectively, are accessing this life-saving medication.

The urgency of this matter cannot be overstated. HIV does not discriminate, but our healthcare system and societal structures often do. As a matter of social justice, public health and human rights, we cannot continue to allow disparities in HIV infection rates and access to resources to persist.

To bridge the gap, we must take a multifaceted approach:

Increased Federal Funding: We need to allocate more resources to targeted education, prevention, and care initiatives in Black and Latino communities. This funding should be directed towards expanding HIV prevention and education programs, as well as improving access to testing and treatment services.

Cultural Competency: Minority-led organizations that possess the cultural and linguistic competencies to effectively service minority communities must be viewed as an essential asset in the fight against HIV and supported accordingly. Additionally, healthcare and other providers must undergo cultural competency training to ensure that care is sensitive to the unique needs and challenges faced by Black and Latino individuals. The evidence shows that cultural competency and building trust within these communities is essential for effective prevention and treatment.

Community Engagement: Community involvement is key to success. Empowering local organizations and community leaders to actively participate in HIV prevention and treatment efforts can lead to more targeted and effective interventions.

Education and Awareness: Comprehensive and culturally relevant HIV education campaigns should be developed to combat stigma, raise awareness, and encourage regular testing and prevention measures within minority communities.

Access to PrEP: We must work tirelessly to close the gap in access to PrEP. This includes reducing barriers such as cost, stigma, and lack of information. Initiatives to increase awareness of PrEP and streamline the prescription process are essential.

Make no mistake, the disparities in HIV diagnosis rates and access to resources in Black and Latino communities are a pressing public health crisis. The statistics speak for themselves, and the moral imperative to act is undeniable. We must invest in these communities, fight for federal programs like The Minority AIDS Initiative, and work tirelessly to address disparities in infections and access to care. HIV/AIDS is a battle that we can win, but it requires unwavering commitment and resources. The time to act is now; the lives of countless individuals depend on it.

Alphonso David serves as the President and CEO of the Global Black Economic Forum and Maya Rockeymoore Cummings is a Distinguished Presidential Research Fellow in Residence at Johns Hopkins University Bloomberg School of Public Health.